A sixty-year-old woman presented with erythema and nodules involving her whole body for six months and her left lower extremity got injured in a traffic accident one month before the lesions occurred.Cutaneous physical examination revealed several dark red nodules with 1-4 cm diameter were generally arranged in a line on her left upper limb,both legs,dorsum of feet and left inguen.Besides,the nodules presented with well-marginated boundary,hard texture,obvious tenderness and apparent fluctuation.Furthermore,swelling superficial lymph nodes with different size were found in the head and neck,axilla and inguen region.The skin biopsy of the left hip nodular:absence of epidermis,dense infiltration of neutrophils,lymphocytes,histocytes and plasma cells in dermis and subcutaneous adipose tissue with extravasation of erythrocytes.The acid-fast staining was positive which indicated an infectious skin disease.Moreover,the diagnosis of Mycobacterium avium complex infection was confirmed by PCR-reverse spot hybridization test in the pathological tissue.The patient's lesions got improved by anti-infection treatment with amikacin,moxifloxacin hydrochloride and clarithromycin.%60岁女性患者,全身红斑、结节伴疼痛6个月.起病前1个月有左下肢车祸外伤史.皮肤科查体:左手腕部、前臂、双小腿、足背及左侧腹股沟各可见数个直径1～4 cm、大致呈串珠样排列的暗红色结节,界清,质硬,触痛明显且有波动感,头颈部、腋窝及腹股沟可触及数个大小不等的增大淋巴结.左侧髋部结节组织病理:表皮缺失,真皮及皮下脂肪组织内可见大片密集的中性粒细胞、淋巴细胞、组织细胞及浆细胞浸润,红细胞溢出,见大量抗酸杆菌.皮损组织分枝杆菌PCR-反向斑点杂交试验结果明确为胞内鸟分枝杆菌感染.予以阿米卡星、盐酸莫西沙星、克拉霉素抗感染治疗后病情好转.
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